Sexual abuse and HIV risk behaviour among black and minority ethnic men who have sex with men in the UK

Abstract

Black and minority ethnic (BME) men who have sex with men (MSM) face a major burden in relation to HIV infection. It was hypothesised that sexual abuse would be a significant predictor of sexual risk-taking, and that the relationship between sexual abuse and sexual risk-taking behavior would be mediated by victimisation variables, namely homophobia and racism, and maladaptive coping strategies namely drug use. 538 BME MSM completed a survey. 54% reported no sexual abuse whereas 27% reported having experienced sexual abuse. Mann Whitney tests showed that victims of sexual abuse reporter higher frequency of drug use and higher frequency of both homophobia and racism than those who reported no prior sexual abuse. A structural equation model showed that the experience of sexual abuse was positively associated with sexual risktaking and that this relationship was mediated by victimisation variables: frequency of racism and frequency of homophobia, and by the maladaptive coping strategy variable: frequency of drug use. The findings strongly support the need for psycho-sexual and behavioural interventions among BME MSM that consider the possibility of prior sexual abuse and its impact for susceptibility to subsequent forms of victimisation and to drug use.